Summary NCLEX-RN MUST KNOW MEDICATIONS

NCLEX-RN MUST KNOW MEDICATIONS 1 P H A R M A C O L O G Y F O R T H E N C L E X - R N MUST KNOW DRUGS 2 ALTEPLASE • MOA – thrombolytic – plasminogen activator – • Indications – MI – Acute ischemic stroke – Occluded Central lines 2 • Nursing Considerations – Contraindicated in active bleeding – Monitor for active bleeding (q15m x 1hr; q15-30m x 8hr) – May cause intracranial hemorrhage – Monitor for anaphylaxis – Use caution with uncontrolled hypertension – Assess neuro status during therapy • 3 A patient is admitted to the emergency department with chest pain. An electrocardiogram shows changes consistent with an evolving myocardial infarction. The patient’s cardiac enzymes are pending. The nurse caring for this patient will expect to: A. administer aspirin when cardiac enzymes are completed. B. give alteplase [Activase] within 2 hours. C. give tenecteplase [TNKase] immediately. D. obtain an order for an INR. 4 A patient is admitted to the emergency department with chest pain. An electrocardiogram shows changes consistent with an evolving myocardial infarction. The patient’s cardiac enzymes are pending. The nurse caring for this patient will expect to: A. administer aspirin when cardiac enzymes are completed. B. give alteplase [Activase] within 2 hours. C. give tenecteplase [TNKase] immediately. D. obtain an order for an INR. 5 ATORVASTATIN • MOA – HMG-CoA reductase inhibitor – lipid lowering agent – • Indications NCLEX-RN Mus5t Know Medications 1 – • Indications – Management of hypercholesterolemia (primary prevention of cardiovascular disease) 2 • Nursing Considerations – Contraindicated in active liver disease – May cause rhabdomyolysis – Monitor renal function – Monitor serum cholesterol before treatment and 4 weeks after starting therapy – Monitor LFTs – Instruct patient to report muscle weakness (sign of rhabdomyolysis) 6 A patient who is recovering from a STEMI 3 months prior is in the clinic for a follow-up evaluation. The patient is taking 81 mg of aspirin, a beta blocker, and an ACE inhibitor daily and uses nitroglycerine as needed for angina. The patient’s BMI is 24.5 kg/m2, and serum LDL is 150 mg/dL. The patient has a blood pressure of 135/80 mm Hg. What will the nurse expect the provider to order for this patient? A. An antihypertensive medication B. Counseling about a weight loss diet C. Discontinuing the ACE inhibitor D. High-dose statin therapy 7 A patient who is recovering from a STEMI 3 months prior is in the clinic for a follow-up evaluation. The patient is taking 81 mg of aspirin, a beta blocker, and an ACE inhibitor daily and uses nitroglycerine as needed for angina. The patient’s BMI is 24.5 kg/m2, and serum LDL is 150 mg/dL. The patient has a blood pressure of 135/80 mm Hg. What will the nurse expect the provider to order for this patient? A. An antihypertensive medication B. Counseling about a weight loss diet C. Discontinuing the ACE inhibitor 8 D. High-dose statin therapy ACETAMINOPHEN • MOA – non-opioid analgesic – prostaglandin inhibitor – • Indications – Pain – Fever 2 • Nursing Considerations – Do not exceed 4g of acetaminophen per day to limit risk of renal, liver and cardiac damage Overdose will lead to hepatotoxicity